This blog documents the journey of Marla Crider, a 60 year-old travel professional from Little Rock, Arkansas, as she battles a breast cancer called invasive ductal carcinoma (stage 3). From the moment of her diagnosis, she chronicles her experience. Be forewarned this blog may provide a raw glimpse into the author’s psyche and ability to deal with a life threatening challenge. Hopefully, her honesty and humor will provide advice and help to others who find themselves in a crusade of their own.

Tuesday, November 5, 2013

When I awoke on the morning of October 11, I was
surprisingly calm and ready for what the day would bring. My brother and sister-in-law, Marion and
Carolyn, had driven from Northwest Arkansas
the day before and spent the night with me.
Their presence provided me with much needed emotional support as I
prepared for life-changing surgery.

Marla Crider, post-mastectomy surgery.

Even though the mastectomy procedure was scheduled on my
older brother Mike’s birthday, he and my sister-in-law, Barbara, made the trip
from Springdale
to be with me, just as they had done when I had chemo treatments.They met Don, Marion, Carolyn and me at my condo about
thirty minutes before we were to all depart for UAMS.As we sat in my great room talking and
laughing, I looked around me and became a little misty-eyed. I knew my parents
were observing from heaven and proud that their sons were still looking after
their baby sister.

We left the condo at 9 a.m. in order to find the visitor parking
deck and patient registration area at the med center’s main hospital before my
assigned check-in time of 9:30 a.m.Fortunately, living only10 minutes from the University of Arkansas
for Medical Sciences campus allowed us plenty of time to find our way. Don and
I departed in his vehicle and my brothers followed in theirs.We were given directions of where to park by
a nurse the previous day; however, it should have been a red flag when she used
the term “loop-de-loop” in the details.

When we approached said “loop-de-loop,” we learned quickly
that it was an employee only parking deck with no access.There we were in a three-car caravan all
trying to back-up and figure out what to do next.Then, my sister-in-law saw a sign that
suggested we go further up the drive.Sure enough, there was the second “loop-de-loop.”Really?Who designs a double-looped entry into a parking deck?Aren’t they confusing enough without making
it worse? It was now 9:25 a.m. We made our way into the deck and searched for
parking.We lost Mike and Barbara somewhere
in the parking garage and decided they were on their own.We located two parking spaces in close
proximity to each other.Our next
challenge was to find elevator B that would take us to the patient registration
area.Don, Marion, Carolyn and I
wandered around the loop-de-loop, or should I say “blankety blank” parking garage
and finally located the elevator by accident. Just as we stepped inside, my
cell phone rang.I recognized the number
as the UAMS exchange.I answered.It was the pre-op nurse wanting to know where
I was.“Lost,” I said with an
exasperated tone.She tried to instruct
us where to go but the elevator doors closed, which disconnected the call. It
took us another five minutes but we finally found our destination. A few
minutes later Mike and Barbara appeared and reported that they would never find
their vehicle again.

After filling out the obligatory paperwork, I was escorted
to the pre-op area and taken to a prep room.My assigned RN gave me a gown, circulation stockings, no-slip socks and
an elasticized cap to put on in preparation for the surgery.As I disrobed and looked at my reflection in
the glass of a medical equipment cabinet, I couldn’t help but stare at my
breasts one last time. I wasn’t really
sad, just relieved that phase two of my wellness plan was about to get
underway. I bid “the girls” good-bye and finished dressing in my surgical
attire.The nurse returned and started
taking my vital signs then gave me a small dispensing cup with a pill in
it.She explained that it was a marisol
capsule – marijuana – that would help me relax and eliminate post-surgery
nausea. Hmmmm. Marijuana in a red capsule.I wondered if I would have a case of the munchies when I woke up after the surgery.

The nurse beckoned my family from the waiting area and told
them they could see me before I was moved to surgery.My brothers, their wives and Don were in the
small room along with my pre-op nurse and the nurse anesthetist.The door opened and Dr. Klimberg entered. She
looked a little surprised to see so many people.Before I could introduce her to my family,
she immediately acknowledged them, introduced herself and then walked to my
bedside.

“What’s your name and what are we doing to you today,” she
asked with her typical dry wit.“Very
funny,” I responded.She smiled, patted
me on the arm and told my family they would take good care of me. At that
very moment my vision began to blur and I couldn't stop smiling.It was the marisol.One by one, my family and Don kissed me on
the forehead and returned to the waiting room where they would spend the next
four hours.

The pre-op team transported me to the operating room as I
struggled to focus on what they were saying. The marisol pill had really affected
my senses. I saw a clock on the wall.It
was 10:50 a.m.It was the last thing I
remembered.

I was desperately trying to open my eyes when I heard a
voice ask if I was in pain.“I’m
hurting,” I responded in a whisper.“I’m going to give you some morphine before we move you to
your room,” the post-op nurse said.

A few minutes later, five people were lifting me from the
gurney to the hospital bed in my assigned room, trying with all their might not
to cause me any additional discomfort because the morphine had yet to kick-in.
A certified nurse’s assistant (CNA) quickly placed pillows under each forearm,
which helped alleviate some of the pain.She raised the head of the bed so that I was in an upright position.The clock on the wall showed 5:20 p.m. What a
long day for my family, I thought.About
that time, Don, Marion and Carolyn entered the room.I didn’t see Mike and Barbara. I assumed they were
searching for their car. Marion
explained that after Dr. Klimberg came out of surgery to give them an update,
Mike and Barbara drove back to Springdale
for Mike’s birthday celebration with their kids and grandchildren. I was glad his special day wasn’t totally
upstaged by my surgery.

I could smell food in my vicinity, which made my hunger
pains even more severe.Yep, I had the
munchies.There were no symptoms of
nausea, which cleared the way for me to receive a food tray. I hadn’t eaten in
24 hours. Since I couldn’t move my arms, Carolyn fed me. Dinner was a lemon pepper chicken breast and
rice and it was yummy.Dessert was
sugar-free, cherry Jell-O.I kept
telling Carolyn it was the best I had ever had. It must have been the marisol talking.

The next 12 hours were filled with the medical team taking
vital signs, monitoring my blood sugar and dispensing medications.There was some concern because my blood sugar
registered 250 and it should have been somewhere between 80 and 120, which is
normal.Dr. Klimberg left orders to give
me several units of insulin to bring it down.The RN noted that the glucose included with my intravenous meds was probably the
culprit for the high reading.

Illustration showing how drainsare inserted post-surgery.

Marion, Carolyn and Don agreed that Don would spend the
night in the room with me should I need assistance. They planned to return early
the following morning to relieve him. Don didn’t get much rest because I was
monitored every two hours throughout the night.That’s when I realized that the RN was checking fluid in bottles – one
on each side of me.As the anesthesia
began to clear my brain, it dawned on me that the bottles were the infamous
drains that I had heard so much about.The
plastic bottles had measuring units on them to determine how much blood and
serum was draining from my breast cavities. At one point, when I tried to adjust myself in the hospital
bed, I felt a pull on my side and asked Don about it.He explained that it was the drain tubes that
were inserted and stitched under each arm.

At 4:30 a.m., the CNA came in and had been instructed to
remove my catheter.At 4:30 in the
morning?After the task was completed, I was told to
ring the nurse if I had to pee and someone would assist me to the
bathroom.I was not
looking forward to getting up considering I couldn’t even lift my arms.

At 6:30 a.m., I had to make the dreaded call to the nurse
and request help to get out of bed for my first post-surgery trip to the bathroom.There had been a shift change and a male CNA
arrived to help. He coached me to use my legs, rather than my upper body,
to change positions.I managed to swing
my legs off the side of the bed without using my arms.When I returned from the bathroom, Don
suggested I sit in a chair for a while and rest my back.It felt good to sit up.

Dr. Tummel, the resident who assisted Dr. Klimberg in
surgery, was making rounds and stopped by at 6:45 a.m. to check my incisions
and the swelling.He said everything
looked good but he wanted Dr. Klimberg to see me, as well. In the meantime, the
RN came in to check my blood sugar; it was 230. He suggested that it was time
to remove my intravenous line and the pesky glucose that was escalating my
blood sugar.I was thrilled because the needle was making my hand and arm ache. The nurse injected me with two units of
insulin to help decreast my sugar levels. My usual daily dose is 32 units.I didn’t expect there to be much change.

I was still sitting in the chair at 7:10 a.m. when my door
opened and Dr. Klimberg came in accompanied by Dr. Yuen, the plastic surgeon
who will eventually handle my reconstruction surgery. Much to my surprise, five or six med students
followed Dr. Yuen into the room.Dr.
Klimberg sat on the edge of the bed and asked if she could show Dr. Yuen the
first ever, modified “Breast Over Pants” procedure she did just for me.

“Sure,” I said, “but I thought you couldn’t do the ‘Breast
Over Pants’ because my breasts were too small.”

“You aren't going to let me forget that are you," she asked. I shook my head no. "Well, I did a variation and wanted to show Dr. Yuen since he’s
never seen it before,” she responded.Both surgeons began pressing on my numb nipples as the med students
moved in for a closer look.It was
definitely a Grey’s Anatomy moment, only Dr. McDreamy wasn’t among the McYoungsters.
Dr. Yuen proclaimed that Dr. Klimberg’s skin-saving procedure would allow him
to adequately insert the prosthesis without having to make adjustments.I was pleased.Dr. Klimberg was pleased. And the med
students didn’t have a clue what he was talking about.

Before Dr. Klimberg left my room, she reassured me that the
surgery went very well.She instructed
me not to lift, pull or raise my arms above elbow height for the next two
weeks. The drains were scheduled to be removed in ten days at her office. She
told me she would notify me as soon as she received the pathology report, but
it was really good news that the cancer had not infiltrated any lymph
nodes, based on the preliminary results during surgery.I tried to high five her but
decided that probably wasn’t a good idea.

After Dr. Klimberg departed, one of the med students
returned to my room with camera in hand.I couldn’t imagine what he was planning to do.

“Dr. Klimberg sent me to take a photograph of your chest and
her handiwork,” he explained.I laughed
as I opened my hospital gown for the photo.

“Will my boobless, yet well preserved chest be featured in
one of her medical books,” I asked the young student.“Maybe.You never know with her,” he responded. After
two clicks of the lens, the Dr. Klimberg wannabe quickly exited my room.

The RN entered my room and reported that Dr. Klimberg
had signed my release orders.I was
shocked but thrilled that she was going to allow me to go home so soon;
however, there was one stipulation. My blood sugar had to drop below 200 before
I could leave the hospital.The nurse
gave me another 30 units of insulin to help me meet the goal.All we had to do was wait.

By this time, Marion and Carolyn had arrived to relieve
Don.They were stunned that I was on the
fast track for going home.In
anticipation of my departure, Carolyn helped me change out of my hospital gown
into leggings that she had to pull up for me.Obviously, I didn’t think about my limited arm movement when I
packed.I brought a tunic for the trip
home; however, there was no way we could fasten it over the drain bottles and
tubing.I had to wear my short robe over
the leggings.I was ready to go as soon
as the nurse rechecked my blood sugar.

Meanwhile, the CNA came into my room with a black apron very
similar to a carpenter’s apron.I couldn’t
figure out its purpose. The CNA helped me stand up then tied the apron around
me.She placed the left drain bottle in
the left front pocket of the apron and the right one in the right front pocket.
It was the perfect solution to a bulky
problem.

It had been 90 minutes since I received the 30 units of
insulin.The nurse came in and checked
my blood.It was 130.Yippee, I was going home and it was only 10:45.There was already a wheelchair waiting for
me.Marion left to get his car and planned to
pick me up in front of the loop-de-loop. Carolyn gathered my things and walked
beside the wheelchair as the CNA took us to the front door.

Getting me into the car was challenging but the marisol pill
given to me before my departure from the hospital made it a non-event. I felt nothing. The short drive home caused me to be
slightly nauseous but the pill helped. All I wanted to do was get to my condo
and deposit myself in my recliner…and eat a batch of brownies.I had another case of the munchies.When we arrived, I managed to maneuver myself
out of the car and up the front steps.I headed
straight for my recliner.In my marisol
and Percocet fog, I reflected on how many people it had taken to get me through
chemotherapy, surgery, and now post-surgery recuperation. I thought to myself, it
truly does take a village to cure cancer. It was the last thing I remembered for several hours.

About Me

Marla Crider, a 60 year-old travel professional from Little
Rock, Arkansas, is blogging her battle with invasive ductal carcinoma or in layman’s terms –
breast cancer. From the moment she discovers the lurking lump in her right
breast, she apprehensively chronicles her thoughts and emotions for public
scrutiny. Be forewarned that these postings may provide a raw glimpse into the
author’s psyche and ability to deal with a life threatening challenge. Hopefully,
Marla’s honesty, humor, and prose approach of dealing with her diagnosis and
subsequent treatment plan will help others who find themselves in a crusade of
their own. You may follow her journey here: www.MarlaCrider.com . Marla has lived and worked previously in Fayetteville, Arkansas and Hot Springs, Arkansas.

Invasive Ductal Carcinoma: What is it?

Invasive ductal carcinoma (IDC) is the most common form of invasive breast cancer. It accounts for 80% of breast cancer incidence upon diagnosis, according to statistics from the U.S. in 2004. On a mammogram, it is usually visualized as a mass with fine spikes radiating from the edges. On physical examination, the lump usually feels much harder or firmer than benign breast lesions such as fibroadenoma. On microscopic examination, the cancerous cells invade and replace the surrounding normal tissues.

Mammograms

Breast tissue is composed of fatty (nondense) tissue and connective (dense) tissue. Radiologists use a grading system to describe the density of breast tissue based on the proportion of fat to connective tissue. There are four levels of density that are detected by mammograms: Level 1 (a very fatty breast), level 2 (fatty tissue makes up more than 50 percent of breast), level 3 (dense tissue makes up more than 50 percent of the breast) and level 4 (a very dense breast with very little fat). Click the image above for more information from the Mayo Clinic.

Get a Breast Cancer Screening

Click map to find a screening site near you.

All original content copyright (c) 2013, Marla F. Crider and marlacrider.com. You are free to share (copy, distribute and transmit) content from this site with attribution to marlacrider.com.